Einstein works to cut premature-birth rate through group appointments

Under the group-appointment approach, a nurse-midwife meets with eight to 12 women due to deliver around the same. Actual physical exams are handled during regular appointments, but OB-GYN Arnold Cohen says the group covers a lot.

"They are taught to take their own blood pressures, or take their neighbors' blood pressures," Cohen said. "They measure their abdomen, they go over the signs and symptoms and complications of pregnancy together."

A small number of Einstein patients already join a group. Under a new policy, all low-risk women with a healthy pregnancy will be signed up, unless they opt out.

"Unless they don't want to have this, this is the way we will carry out business," Cohen said.

Positive impact expected

Experts at Einstein say they're convinced that group appointments, and some extra support and education, may help lower the number of babies born too early.

Sarri Williams, 18, was pregnant for the third time when she joined a group. This time around, she said, she really heard the warnings about putting her baby to sleep safely.

"I never paid attention, because no one actually enforced it," Williams said. "So I didn't think it was a big deal until we watched a couple of videos and we talked about it for awhile. I finally got the point, I'm going to try it differently."

Williams' daughter Essence Keck was born in January.

"In the group, we got to talk about stuff, what to expect, and how to cope with it," Williams said. "I was able to talk to them even if I wasn't able to talk to someone at home. It was very comforting and helpful."

Cohen says women who join these groups are less likely to miss appointments and more likely to follow their doctor's instructions.

Program expands with U.S. help

Einstein is expanding its group-appointment program with grant money from the U.S. Department of Health and Human Services. The "Strong Start" award is designed to improve prenatal care for women covered by Medicaid.

There are about 3,000 deliveries at Einstein each year, and Cohen said about 80 percent of those patients get their insurance through Medicaid.

The women share information on breastfeeding, labor and delivery, and pain relief options ... and there are snacks.

"It's more than the 10- or 15-minute visit they would normally have with an obstetrical care provider," Cohen said.

The cost, he said, is about the same as routine care.

About 500,000 infants are born prematurely in the United States, according to the federal health officials. Those deliveries often cost more than other births and children born early often need "early intervention services and special education."

"They are taught to take their own blood pressures, or take their neighbors blood pressures. They measure their abdomen, they go over the signs and symptoms and complications of pregnancy together."
--Arnold Cohen, OB-GYN, Albert Einstein Medical Center

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Picture of Essence Keck, born in January. Her mother Sarri Williams participated in group OBGYN appointments for pregnant women at Albert Einstein Medical Center. (Family photo courtesy of Sarri Williams)

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